Failed Back Surgery

What is nerve root pain in "Failed Back Surgery"?

After an operation for a herniated (slipped) disc sometimes the
pain caused by the nerve root continues to radiate down the leg
even though the herniated disc is no longer pressing on the nerve
root. This is known as nerve root pain or radiculopathy.
It is also sometimes called "Failed Back Surgery
Syndrome".

Cause

The herniated disc damages the nerve root so it no longer works
properly. The nerve root itself then starts to produce small
electrical discharges that go through the spinal cord up to the
brain and cause the radiating pain in the leg.

Signs and symptoms

The main symptom of nerve root damage is pain that starts in the
back and radiates down the leg. This pain is often sharp and
stabbing. In addition, there may be some numbness, tingling or
weakness of the muscles.

How is "Failed Back Surgery" diagnosed?

If someone has pain that radiates down the leg, it is very
likely to be nerve root pain. A neurological examination includes a number of tests
that can confirm this.
In addition to neurological examination, the movement of the back
is examined to see if it is limited or painful. The back is also
examined to see if any of the vertebrae hurt when they are
pressed.

Do I need additional examinations?

Diagnostic examination for other non-physical factors important
for your pain, have already been done by yourself trough filling
out your pain questionnaires. As the
neurological examination usually confirms the diagnosis, extra
tests will not always be necessary because they will not affect the
treatment in any way. It is important to know that images
from MRI scan have shown
many people have a herniated disc even though they have no signs or
symptoms. In the same way, MRI images of the back show that some
people who have pain radiating down their leg and whose doctors
think that they have a herniated disc, do not have a herniated disc
at all.

For this reason, it is only useful to do an MRI scan if the
diagnosis is uncertain. An MRI scan may also show up other
causes. A CT scan
is not useful as this really only shows the bones.

It is also possible to do an examination of the muscles (EMG) in order to find out
which nerve root is causing the pain.

What are my treatment possibilities?

Multidisciplinary treatment

Depending on the cause of your pain, your pain specialist will
decide whether or not to start physical treatment. Based on the
results of the completed pain questionnaire, additional
examinations can be carried out and, apart from physical treatment,
other methods of treatment will be suggested.

Non-physical treatment

If the results of your pain questionnaire are abnormal, your
pain specialist will offer you one of the non-physical treatments
listed below:

Pijn.com provides reliable information on the diagnosis and treatment of chronic pain. Complaints such as scar tissue pain, herniated discs or neuropathic pain are discussed.

The University Pain Centre Maastricht (UPCM), led by Dr. Sommer of the Maastricht UMC +, has received of the World Institute of Pain (WIP) the highest possible award, known as the Excellence in Pain Practice Award for Comprehensive Multidisciplinary Pain Practice. There are only a few other pain centres worldwide that have received this award. In particular the multidisciplinary approach of the University Maastricht Pain Centre is praised by the WIP.